Tirosint-who here is on it?

[bedheadblonde]

I  decided to make the switch from generic to Tirosint, and took my first dose today. Obviously I'm not going to feel anything for a while yet, but those of you on it, how do you like it?

[bedheadblonde]

Oh, I forgot, I was having most the symptoms of hyper you can find on the checklist-tremors, weight loss despite eating constantly, (nearly 30 pounds in just a few weeks) hair loss, eyes bulging slightly and feeling irritated and gritty, higher blood pressure, rapid pulse (we're talking 120 at rest) anxiety, panic attacks out of nowhere, sweating, etc. Once I got on methimazole, in about six weeks I gained a good amount of weight back,  stopped losing hair, eyes felt better, tremors stopped, pulse returned to normal, no anxiety any more. It was like night and day.

[bedheadblonde]

Yes, I was diagnosed with Graves'. My FT4 was always borderline high and my TSH kept fluctuating between just above the danger zone number for hyperthyroidism/into hyperthyroidism when I was initially having testing done. TSI was borderline high, and the other two antibody tests (I think the AB ones, I can't recall the exact names) were (and still are) extremely low in range when tested, so Hashi's was ruled out since I also did not have any period of my thyroid swinging hypo at all during this time, even when put on methimazole. Uptake and scans I had were indicative of Graves' disease and not Hashi's (normal range after 24hrs is an uptake of 0-30% or so, and mine was 74% before my first RAI and 48% my second time, respectively). The nuclear specialist who read the pictures said it was a Graves' thyroid and not Hashi's.That's what seems odd about the FT3 tests I had done, they did seem low in range, but I was indeed tested positive for Graves' disease, so I don't understand what's going with my FT3 in my body, to be honest.

[Barb135]

As I said, Total T3 is obsolete and of little value; you might as well tell your doctors to save you the money and not run it anymore.

Neither a 3.1 or 2.7 FT3 would be considered hyper, unless you're ultra sensitive, which happens, but is pretty rare.  2.7 with a range of 2.4-4.2 is only 16% of the range.  3.1 with the same range is only 38% of the range and rule of thumb to eliminate hypothyroidism is for FT3 to be in the upper half to upper third of its range.  

What are the hyper symptoms you were having?  Have you been diagnosed with an autoimmune thyroid disease?  That would be either Graves Disease or Hashimoto's Thyroiditis?  

Graves Disease is associated with hyperthyroidism.  Hashimoto's is most often associated with hypothyroidism, but can be characterized by periods of hyperthyroidism in the beginning, which can alternate with periods of normal or hypo, often swinging back and forth.

[bedheadblonde]

Oh yeah, I do agree, it's more about being 'in range,' it's how you feel. Before I finally got on medication for Graves', my levels on labs would be considered just over normal/borderline high normal, (epescially FT4, it always rang up at the end of normal-1.8) so a lot of doctors assumed I was making it up, I was depressed, etc., yet I felt terrible and had all the symptoms of hyperthyroid. The uptake and scans I eventually had proved I *was* hyperthyroid, though. The only times I had FT3 done, I had yet to go hypothyroid. 2.4 - 4.2 is the range my lab for FT3 goes by, and I rang up at 3.1 twice (once as I was experiencing hyperthyroid symptoms but yet to be diagnosed, the other four months after my first RAI,)and a 2.7 right before my very first RAI (however, I was on methimazole at the time of that one.) When total T3 was ran with them, I was in the 100's and felt pretty hyper. I'm not sure if 3.1 would be considered mid range at that time? I'm not honestly sure if I'm an anomaly, or just have a conversion issue we need to look at. I do know I felt better taking methimazole for a year after diagnosis, and after my first RAI, when my TT3 was lowered into the 80's and 90's.

[Barb135]

Don't wait for your doctors to ask for Free T3 - you need to ask them to order it "every" time you have labs.  Symptoms correlate much better with Free T3 and do not correlate at all with either TSH or Free T4.

Rule of thumb is to have FT4 at about mid range; yours is 67% of the range, which is quite a bit higher than it should be.  

Total T3 is considered obsolete and of little value; that said, yours is very low in the range, so we can presume that your FT3 would also be low in the range.  Rule of thumb is to have FT3 in the upper half to upper third of its range.

Just being "in range" is not enough with thyroid hormones; they have to be adjusted to what's best for you. And I'm talking about FT3 and FT4, because TSH rarely reflects what's going on.

[bedheadblonde]

Right now, we did the same dose-was on 88mcg of generic, now on 88 of Tirosint. They sadly rarely ask to get FT3 done (I need to get it done myself, me thinks) but on October 25th, my labs were:

TSH-4.04 (range of 0.45-4.55)
Free T4- 1.5 (lab range 0.9-1.8)
Total T3- 71 (range of 60-180)

Now though these fall in 'normal' ranges, I know (and so do my endos)from past experience I feel better with my TSH at around a 2 or so with my FT4 about the same as it is now. My TT3 in the past when feeling good was in the high 80's-mid 90's. (this was after being on medication for Graves'/after my first RAI last year and feeling good before I went hyper again and needing a second one.)The reason they decided to stay on the same dose is because they want to see if my stomach will better absorb the gelcap, however I was warned that I may need a lower dose, so I have an 'emergency lab sheet,' so to speak (to go get blood drawn if I start to feel hyper symptoms before the six weeks that persist) and I also will still keep an eye on that T3 and ask about adding the touch of Cytomel and dialing back the Tirosint if needed.

I'm glad you do well on it! Generic just isn't cutting it for me, and though I have no allergies or digestion problems, I felt like trying the gelcap before asking about Synthroid was a good way to go-I tend to respond quicker and better to things like gelcap pain relief and the like.

[Barb135]

Tirosint only came on the market in May 2009; I've been on it since Aug 2009.  Personally, I love it.  

I have issues with absorbing nutrients, medications, etc, so it works very well for me, because it dissolves fully and is more readily absorbed.

What dose of generic were you on, and what dose of Tirosint did you start at? Many people find that they have to start Tirosint at a lower dose than what they were previously on, because of the better absorption.

What are your current thyroid hormone levels? Please post reference ranges with any lab results, as ranges vary lab to lab and have to come from your own report.